Abstract:Objective:To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).
Methods :The clinical data of 6 patients with PTC were retrospectively analyzed.
Results:Five patients complained of primary hyperparathyroidism, 3 patients had manifestations of palpable neck mass, 4 patients were admitted for hypercalcemia with calcium level of (3.62±0.56 )mmol/L, and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit. Frozen section histopathology established diagnosis in 3 patients, routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients, and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient. Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients, who were followed up for 1-5 years, recurrence in 1 patient 3 years after operation; tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis, and the patient died of MOF 16 days postoperation.
Conclusions:The diagnosis of PTC is difficult before operation. Routine blood examinations, blood PTH , 99mTc-MIBI scintigraphy, ultrasonography, CT, observation of specimen, and frozen section histopathology during operation are helpful to diagnosis. The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.